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July 2017

Fasting: An Old Tradition Receives Another Look

The medical traditions of many cultures consider our diet to be central to health. This includes not only what we eat, but how and when we eat, and the environment in which we choose to eat.

Perhaps a better word than “eat” would be “nourish” as in the traditional viewpoints of Chinese, Tibetan, Ayurvedic, Unani-Tibb, and Ifa medicine, creating a meal that satisfies the spiritual and physiologic needs is purely medicine.

Yet, my modern training included very little of this perspective. Although the medical elite drone on endlessly about “healthy eating” or “healthy choices”, there is very little clarity on exactly what this means.

And, as any student of modern medicine can observe, the track record of the medical establishment indicates how very ineffective their collective effort has been:

“The prevalence of obesity among children and adults has doubled in 73 countries since 1980 and has shown a continuous increase in most other countries. Although the prevalence of childhood obesity has been lower than the prevalence of adult obesity, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity.” (N Engl J Med 2017; 377:13-27)

Diet related diseases have increased to the point that the majority of physicians’ clinical time is necessary to address them. And, with increasing numbers of children becoming overweight or obese, epidemics of expensive and dangerous metabolic diseases are predicted:

Even now, “Almost one-third of the US population -- 100 million people -- either has diabetes or its precursor condition, known as pre-diabetes, said a government report Tuesday.

Diabetes is a serious disease that doubles the risk of early death. Complications can include blindness, heart disease, stroke, kidney failure and amputation of fingers, toes and limbs.

In the US Centers for Disease Control and Prevention's National Diabetes Statistics Report, released about every two years, the agency described diabetes as a "growing health problem" that was the seventh leading cause of death in the US in 2015.”

Unfortunately, the drugs and procedures that are modern medicine's answer to address the symptoms rather than the causes of this situation add considerable increased cost and a cascade of side effects and complications that themselves create a significant demand on the medical system, as well as increased suffering and death for patients.

Like “wellness”, hearing the phrase “healthy eating” itself takes years off my life. We will be doomed to an endless pattern of treating the symptoms and creating more disease if we don’t address the immediate need to change our cultural mindset on food.

Since every medical school in the United States is still teaching within a 19th century mindset, I think it unlikely that we will see any innovation from this quarter.

Nonetheless, there are some researchers who are finding that techniques such as fasting, well known to the spiritual and medical traditions of the past, may hold some answers to this dilemma.

Fasting has been prescribed considered within traditional Oriental medical both spiritual and medical reasons but researchers have discovered some intriguing scientific evidence to support this practice.

Studies in mice have become well known, with benefits seen in one study of eight days of caloric restriction a month. The mice who experienced this partial fast “lived an average of 11% longer than control mice and had fewer cancers, less inflammation, less visceral fat, slower loss of bone density, and improved cognitive performance.” 1

Humans also seem to be responsive: “In a 2011 cofunded study of young overweight women, a weekly fast- 5 days of unrestricted eating and 2 consecutive days at 75%caloric restriction produced outcomes similar to daily caloric restriction in reducing weight, total and low density lipoprotiein cholesterol, and blood pressure, among other markers.” 1

Another study, where restricting calories 60% for five consecutive days each month indicates that after as little as three months, “the intervention group had lost an average of 6 pounds… had less trunk and total body fat, smaller waist circumference and lower blood pressure and insulin like growth factor ( IGF-1) than the control group.“ 1

In addition, the partial fasting group had improved body mass index, fasting glucose, triglycerides, total LDL and C-reactive protein (a measure of inflammation). It was encouraging that there was a trend for a more pronounced improvement among those who started the study with worse numbers.